Vol. 8, Issue 1, Part A (2026)

Background: Remission after induction therapy is critical for prognosis in childhood Acute Lymphoblastic Leukemia (ALL). Minimal Residual Disease (MRD) assessment provides a sensitive measure of treatment response beyond conventional bone marrow morphology, potentially identifying key prognostic factors for remission failure.

Objective: To identify prognostic factors influencing remission in pediatric ALL using MRD evaluation after induction therapy.

Methods: This prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University from March 2023 to February 2024. It enrolled 36 newly diagnosed pediatric ALL patients. Remission was assessed on day 29 of induction via bone marrow morphology and MRD examination. Chemotherapy followed a risk-stratified modified UK ALL protocol. Associations between baseline factors and MRD outcomes were analyzed statistically using SPSS 25.0.

Results: MRD-confirmed remission was achieved in 75% of patients. Most participants (86.1%) were aged 1–10 years, with a 74.1% remission rate. Males constituted 63.9% of the cohort and showed a higher, though statistically nonsignificant, rate of remission failure (34.8% vs. 7.7% in females; p = 0.067). The majority had normal nutritional status (75%). ALL-L1 was the predominant FAB subtype (69.4%), and B-cell lineage was the most common immunophenotype (97.2%). Standard-risk (63.9%) and high-risk patients received Regimen A and Regimen B chemotherapy, respectively.

Conclusion: This study identifies trends associating male gender, undernutrition, high initial leukocyte count, low hemoglobin, and T-cell lineage with higher MRD-positive remission failure. However, these factors do not demonstrate statistically significant associations with MRD status in this cohort.